Clinton Mandates ‘Fair’ Appeals Process for Denied Coverage
President Clinton Saturday ordered Labor Secretary Alexis Herman to establish a "fair and unbiased" appeals process for patients receiving delayed or denied coverage by private health insurance plans, the AP/Dallas Morning News reports. Still, he said that the action "does not go far enough" and urged voters to demand patients' rights legislation from Congress. "The only way to do those things is to pass a real, enforceable patients' bill of rights," Clinton said Saturday during his weekly radio address, adding, "The American people can make sure that will happen by voting [for Democrats]." The Department of Labor will release the final internal appeals and consumer information regulations in two weeks. According to the White House, under current law, health plans making coverage decisions "often do not have [necessary] medical expertise," and appeals of "adverse actions" can last as long as 300 days. "Countless patients have been harmed by inappropriate delays and denials of coverage," the White House argued in a statement, adding that the new regulations would establish a fair process for reviewing benefits, require "timely" decisions and ensure that patients receive information about their right to appeal. The executive order will affect 130 million employees and family members enrolled in private, employee-sponsored health plans (AP/Dallas Morning News, 11/5).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.